急性大面积肺栓塞静脉溶栓患者的观察与护理

发布时间：2019-05-15 00:16

【摘要】：目的探讨静脉溶栓治疗急性大面积肺栓塞患者的护理方法。方法回顾性分析2015年同济大学附属上海市肺科医院心肺循环科治疗的36例急性大面积肺栓塞患者的临床资料。所有患者均给予微量注射泵静脉注射注射用阿替普酶治疗,在溶栓前、中、后均实施对症护理及肺血管病专科护理,严密观察患者的生命体征及穿刺处皮肤等情况,并进行血常规、出凝血时间等实验室检查,及时发现出血等并发症。结果34例患者胸闷、胸痛、气促、呼吸困难等症状缓解,其中:1例患者在腹部皮下注射处出现1 cm×2 cm的血肿;2例患者桡动脉穿刺处出现1 cm×1 cm的血肿,经纱布填塞1 h后,血肿均未见增大,7 d后逐渐吸收;3例患者出现鼻出血,量约30 ml,经纱布填塞后停止出血;2例患者血压为75~80/50~55 mmHg(1 mmHg=0.133 kPa),经升压等急救和护理后均好转;2例患者病死。结论急性大面积肺栓塞患者静脉溶栓治疗期间,及时发现病情变化及出血等不良反应,积极配合抢救,可提高抢救成功率。
[Abstract]:Objective to explore the nursing methods of patients with acute large area pulmonary embolism treated by intravenous thrombolysis. Methods the clinical data of 36 patients with acute large area pulmonary embolism treated by cardiopulmonary circulation department of Shanghai Lung Hospital affiliated to Tongji University in 2015 were analyzed retrospectively. All patients were treated with atepinase for intravenous injection of microinjection pump. Before, during and after thrombolysis, symptomatic nursing and specialized nursing of pulmonary vascular disease were carried out. The vital signs of the patients and the skin at the puncture site were closely observed. Blood routine, coagulation time and other laboratory tests, timely detection of bleeding and other complications. Results the symptoms of chest tightness, chest pain, shortness of breath and dyspnea were relieved in 34 patients. Among them, 1 patient had 1 cm 脳 2 cm hematomas at the subcutaneous injection of abdomen. There were 1 cm 脳 1 cm hematomas at the puncture site of radial artery in 2 patients. After filling with gauze for 1 hour, the hematomas did not increase and gradually absorbed after 7 days, and nasal bleeding occurred in 3 patients, which stopped bleeding after gauze packing for about 30 ml,. The blood pressure of 2 patients was 75 卤80 鈮，

本文编号：2477161